Why Radiologists Miss Lung Nodules on Chest CT and How to Reduce Misses

Small and pure ground-glass lung nodules are the ones most often missed on chest computed tomography (CT), especially near vessels or airways. Reader fatigue and bias also contribute. Knowing these patterns helps radiologists use technical and cognitive strategies to reduce miss…

• The review organizes missed-nodule causes into technical limitations, intrinsic nodule and adjacent structure features, and reader factors such as fatigue and cognitive bias.
• Endobronchial and perivascular nodules are more likely to be overlooked because of surrounding anatomical complexity.
• CT advances and computer-aided detection can improve performance but still have limitations; objective characterization of missed nodules may inform medicolegal standards.

Automated summary

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